Individual
DOMENICA CORONEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1225 BENNETT AVE, APT. 308, LONG BEACH, CA 90804-5925
(310) 938-4460
Mailing address
1225 BENNETT AVE, APT. 308, LONG BEACH, CA 90804-5925
(310) 938-4460
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
260778
CA
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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